How is acute promyelocytic leukemia (APL) diagnosed?

Updated: May 03, 2019
  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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According to National Comprehensive Cancer Network (NCCN) guidelines, multidisciplinary testing (immonohistochemistry, cytochemistry, and molecular genetic analysis) are needed to diagnose APL in accordance with the 2016 WHO classification system. An APL diagnosis requires APL morphology and one of the following [14] :

  • t(15:17) by cytogenetics, or
  • Promelocytic leukemia (PML)/retinoic acid receptor alpha (RARA) by molecular testing

Patients are further classified as low risk (white blood cell [WBC] count ≤10,000/μL) or high risk (WBC >10,000/μL) [14]

If major neurologic signs or symptoms are present, appropriate brain imaging studies should be performed to detect meningeal disease, chloromas, or central nervous system (CNS) bleeding. [14]

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